Examining the relationship between maternal preeclampsia and autism spectrum disorder in childhood.

Researchers studied over 115,000 births to see if preeclampsia (a serious pregnancy complication with high blood pressure) increases the chance of having a child with autism. While they initially found slightly more autism cases in children whose mothers had preeclampsia, this difference went away when they accounted for other factors that might influence autism risk. The study concludes that preeclampsia itself doesn't increase autism risk.

This large retrospective cohort study examined 115,081 deliveries in Israel from 2005-2017 to investigate whether maternal preeclampsia increases autism spectrum disorder (ASD) risk in offspring. Of the mothers, 2,856 (2.5%) had preeclampsia, with 956 cases being severe. While initial analysis showed higher ASD prevalence in children of mothers with preeclampsia (1.1% mild, 0.9% severe) compared to those without (0.7%), this difference disappeared after statistical adjustment for confounding factors. Kaplan-Meier survival analysis and Cox regression models found no significant association between preeclampsia and ASD risk when accounting for relevant variables including gestational age.

The study concludes that preeclampsia does not contribute to ASD development.

Clinicians can provide reassurance to families that maternal preeclampsia does not increase ASD risk in offspring. Results support focusing ASD risk counseling on other established prenatal and genetic factors rather than preeclampsia history.

Retrospective design limits causal inference. Potential for unmeasured confounding factors. ASD diagnostic criteria and timing not specified. Limited generalizability beyond the Israeli healthcare system studied.

Autism spectrum disorder (ASD) has multifactorial origins, some related to the prenatal period. Preeclampsia, a serious pregnancy complication, is also multifactorial. This study aimed to explore the potential association between preeclampsia and ASD in a diverse population. A retrospective cohort study including all deliveries of Clalit Health Services-insured women at Soroka University Medical Center from 2005 to 2017.

The study compared ASD incidence in offspring of mothers with varying severities of preeclampsia. Kaplan-Meier survival curves assessed cumulative ASD incidence, and Cox proportional hazards models adjusted for confounding factors. Of 115,081 parturients, 2,856 (2.5%) had preeclampsia, 956 (0.8%) with severe features. Preeclampsia, especially severe, was linked to adverse outcomes (e.g. fetal growth restriction, earlier delivery, cesarean delivery; < 0.001).

Among 767 (0.7%) offspring diagnosed with ASD, prevalence was higher in the preeclampsia group compared to those without preeclampsia (1.1% mild, 0.9% severe, no preeclampsia 0.7%; = 0.02). However, Kaplan-Meier analysis showed no significant difference in cumulative ASD morbidity (log-rank = 0.928). Cox regression models, conducted both with and without adjustment for gestational age, showed no significant association between preeclampsia and ASD after adjustment for relevant confounders. To gain a deeper understanding of the obstetrical aspects related to the development of autism spectrum disorder, our findings indicate that preeclampsia does not play a contributory role.